Inpatient medicine at the VA hospital is SO much better. I get my own office with a sign outside the door. I get to put in orders. I don't have to see 20 patients a day. In fact, you know how many patients I saw yesterday? 3...all day. 2 in the morning and 1 in the afternoon. It's glorious. I'd go into internal medicine if I could work within the VA system. However, I think pathology is still the place for me.
Anyway, my rant of the day is about the simulated patient H & P that I went through on Thursday. It wasn't pass or fail, so I wasn't worried about it. I went in, talked to the patient, examined her, told her she likely had GERD (acid reflux), and told her to try some OTC Zantac. No problemo. The following is a truncated version of the 40 minutes of hell I went through afterwards
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Dr.Meanie: Do you even know what H2 blockers and PPI's do to a patient with GERD?!
Me: Umm..they lower the lower esophageal sphincter tone, but secondarily help diminish acid production in the stomach. *Look at how much I know!*
Dr. Meanie: Do you have any idea that it is malpractice to prescribe those drugs to someone with GERD?! What if she got an aspiration pneumonia and DIED!? What would you tell the judge? Huh? And don't even get me started on the way you embarrassed yourself with the gown!
Me: Huh? *I guess he'd better tell this to the millions of doctors out there using Prevacid, Nexium, Zantac, etc. Embarrassment? About the gown? What??*
Dr.Meanie: Let's move on and talk about breast exams now. (proceeds to talk a lot about the clinical breast exam and about how I should be feeling up a lot of women)
Me: ......... *Confused at the turn of this conversation, because a breast exam was not warranted in this patient who was complaining of reflux.)
Dr.Meanie: Did you know that young men are unnecessarily using Viagra because they think they'll make their partners orgasm if they last longer?
Me: ........................... *Now, I'm really confused, because this patient was not even a man*
Dr.Meanie: Most women can't orgasm from sex. They need TOYS!! Mechanical stimulation!! (He launches into a really weird conversation about sexual intercourse)
Me: .........*Someone HELP ME! I just want to be anywhere but trapped in this little room with this obviously whacked-out and very creepy old man. What in the hell does this have to do with GERD??!*
Dr. Meanie: "I hope that this session has been of value to you and you will use this in your clinical practice"
Me: Sure. Thank you very much. *Or not, you jackass. I'm going into pathology*
On a side note: How is this uncomfortable talk about women's sexuality (unwarranted, because the patient was complaining of acid reflux) and men's sexuality (irrelevant because the patient was a WOMAN) going to help me? You also insulted me 95% of the time. How is that useful?
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I'll admit it. I'm a little bitter. How was that supposed to be helpful to me? I went through 40 minutes of an old, crabby man holding a one-sided conversation about sex and throwing insult after insult at me. It was ludicrous. Ridiculous. Friggin' insane.
I have never, ever been so insulted this entire year. I admit that there was one 30 minute stretch of pediatrics in which I broke down and cried after an attending's well-meant criticism...but in my defense, I had been up all night on call and was battling a recently acquired pneumonia.
I think I'm going to report him. There was absolutely no excuse for how I was treated.
On a side note, there is supposed to be a Sex & the City marathon on today...but I can find it nowhere on the tube. I'm even more aggravated.
